Worker asks for reimbursement of medical bills, sets off chain of events

Some months after the accident in September 2016, Rajan (not his real name) was back at work on Jurong Island, albeit instructed by the doctor to undertake only “light duties”. One morning in April 2017, heading to his worksite, he was informed by a colleague that the manager had called to ask about Rajan’s particulars, and there was a lorry from the company waiting for him. Rajan knew something was not right – immediately, he ran away, jumped into a taxi and headed straight for a law firm he knew in Chinatown.

Rajan could put two and two together. The company was going to rush him to the airport for immediate repatriation.

“Many people sending like this,” Rajan tells me, referring to other workers before him who were repatriated back to their home town. To avoid the same fate, Rajan had to escape from his employer. The law firm had been recommended to him by his friends, and as he understood it, was a firm with much experience with compensation for work injury cases.

Not long earlier, Rajan had sought reimbursement for his medical expenses. He suspects it was the reason the employer decided to repatriate him.

From the outline of the story so far, it is likely that the employer had not reported the accident to the work safety authorities up to that point. A claim for reimbursement was probably seen by the employer as a risky turn of events; the worker might go to MOM if his claim was not satisfied, and then the cover up (if such it was) would be exposed.

Of course, Rajan is not in a position to know for sure that the employer had not reported the accident, but subsequent events – detailed below – support this interpretation.

The accident and treatment

Rajan injured his back and right hand from a fall while at work. Assistance was initially rendered by the clinic on site, but from Rajan’s telling, he was dissatisfied with the quality of the medical help he received. He was only given painkillers, and the medication didn’t really work, he says.

With persistent pain, he made his own way to Singapore General Hospital where an X-ray s were taken. The scans showed a fracture of the lower back at the L4-L5 vertebrae, but fortunately there were no fractures in his right hand.

Almost immediately, the question of payment became a problem. Rajan paid for the initial consultations, but couldn’t afford follow-up. Apparently, there was an assurance by the company that they would “take care of everything”, but the absence of follow-up appointments or physiotherapy suggests that the company went into arrears with the hospital and treatment stopped.

Company said it was not a workplace accident

The law firm helped Rajan file a work injury compensation claim. Once reported, it became possible to press the employer to pay the medical fees incurred. It is not clear how much success the law firm had.

According to Rajan, the company soon took the position that the injury did not occur at the workplace. This meant that the case was referred to an Assistant Commissioner of Labour for determination.

As at the date of interview, it’s not known what the outcome will be. But a few days ago, Rajan won a small victory – the employer was ordered to permit him access to his worksite on Jurong Island in order to obtain the initial doctor’s medical records. Should his back injury be documented in said records, it will prove, with certainty, that it occurred at work.

No more lawyer

Then things took a twist. Rajan discharged his lawyer.

He says he did so on the advice of MOM. According to his account, MOM told him that a lawyer would not be of much help in this case, as they mostly involve themselves with timely submission of documents, something that the worker can do for himself. Yet, should the worker be ruled to receive any form of monetary compensation, the lawyer still takes a cut out of it, reducing the actual amount the worker gets. TWC2 concurs with this advice.

My take-aways from this case

The issue of disability compensation is a complicated and long standing one. For the process to work smoothly, it requires education and understanding on workers’ part from the moment they arrive in Singapore. Workers have to be informed of the need to be clear and detailed when describing the accident and injury to their doctors. This is particularly important if the doctor is one recommended by their employer – since employers have an incentive to under-declare or play down the seriousness of the accident.

In Rajan’s case, for example, if there is no mention of a possible back injury at the worksite clinic, it will work heavily against him at the next hearing before the Assistant Commissioner of Labour.

The Work Injury Compensation system is a no-fault system, but it doesn’t mean that every injury is covered by it. While the claimant need not prove that the employer was at fault, he may need to prove that the accident happened in the course of work. Yet, it is employers who control the documentation at the worksite; how is the worker to prove it if an employer is determined to cover it up?

The next issue surfaced by Rajan’s story concerns treatment. If an employer does not want an injury to be known to the authorities, there is every incentive to delay or obstruct visits to doctors. It appears, in Rajan’s case, that not only did he have to pay for the initial treatment himself, without financial resources of his own, he might not have been able to continue getting medical care.

As for lawyers – who aren’t needed unless a case goes to court – we see in Rajan’s story why he engaged one. He was facing instant repatriation.

This is compounded by lack of knowledge among workers as to how to file an accident report and injury claim themselves. The government could step in to make it easier and more accessible for them to submit injury compensation claims. There could be free legal clinics for foreign workers, and more regular education on the rights that are theirs.

When workers feel lost in a distant and bureaucratic system, workers naturally look to lawyers to solve every issue they have. But then, the costs charged by law firms service to foreign workers is another concern, reducing what the man may receive to put his life back together again after the accident.

(The interviewee requested anonymity because he had not informed his family that he had suffered an accident.)

TWC2 is an organization that is dedicated to assisting low-wage migrant workers when they are in difficulty. We are motivated by a sense of fairness and humanity, though our caseload often exceeds our means.